Friday, December 19, 2014

What would you rather have?

Most professions have their own silly games. Doctors have a
game called ‘what would you rather have’? There are 2 diseases and you have choose
which one you would rather have. Most people go for something they are familiar
with; I would always choose HIV over Type 1 diabetes but I’m yet to meet an
endocrinologist who agrees with me. Both are incurable and may shorten your
life span a little but HIV can be treated with 1 pill once a day whereas Type 1
diabetes requires multiple injections of insulin and measurements of blood
sugar every day. To me that is a no brainer.

I was recently asked to choose between Ebola and multi-drug
resistant tuberculosis (MDR-TB) and my first thoughts were ‘anything but
Ebola’. But then I thought for a minute; in west Africa around 40% of people
survive Ebola which is exactly the rate of successful treatment for MDR-TB in
low resource settings. In high resource settings the survival rates are also
likely to be remarkably similar, I would guess at around 95%. The treatment for
Ebola is pretty basic and the duration short, whilst for MDR-TB treatment lasts
18-24 months and often comes with crippling side-effects. Put like this it
becomes another no brainer, I’d take Ebola any time.

Few things seem as scary as fighting in the First World War.
Climbing Mt Everest might not seem the safest pursuit but surely it is safer
than that. Actually the chances of a
soldier returning alive from WW I was as high as 90%, I had assumed it was
closer to 10%, and the chances of returning home from an attempt on Everest are
worse. And so it is with Ebola. What seems like the scariest disease in
existence is actually on a par with something much closer to home. Ebola
deserves all the resources and attention is has received but this conversation has
reminded me just how much I have become accustomed to equally horrific
illnesses seen in daily life.